IL-1β及其受体拮抗剂IL-1ra在新生儿败血症合并持续性肺动脉高压中的表达及临床意义  

Expression and clinical significance of IL-1βand IL-1βreceptor antagonist in persistent pulmonary hypertension of the newborns secondary to sepsis

作　　者：张慧平 李思袖[1] 王金会[1] 杨雪峰[1] 刘建萍[1] Zhang Huiping;Li Sixiu;Wang Jinhui;Yang Xuefeng;Liu Jianping(Neonatal Intensive Care Unit,Xi′an Children′s Hospital,Xi′an 710003,China)

机构地区：[1]西安市儿童医院NICU,710003

出　　处：《国际儿科学杂志》2021年第7期498-502,共5页International Journal of Pediatrics

基　　金：陕西省自然科学基础研究计划面上项目(2020JM451)。

摘　　要：目的:探讨白细胞介素-1β(interleukin-1β,IL-1β)及其受体拮抗剂(interleukin-1 receptor antagonist,IL-1ra)在新生儿败血症合并持续性肺动脉高压(persistent pulmonary hypertension of the newborn,PPHN)中的表达及临床意义。方法:收集2018年1月至2020年12月西安市儿童医院新生儿重症监护病房收治的败血症新生儿的相关资料,根据败血症患儿是否合并PPHN分为两组:对照组为败血症无PPHN组(n=108),观察组为败血症合并PPHN组(n=44)。收集所有患儿临床资料、实验室检查及床边超声心动图检测数据,分析两组患儿数据的差异。通过酶联免疫法检测两组新生儿血浆中IL-1β、IL-1ra表达水平。采用多因素Logistic回归分析败血症新生儿合并PPHN的危险因素,采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析IL-1β及N末端脑钠肽前体(N-terminal brain natriuretic peptide precursor,NT-proBNP)对新生儿败血症合并PPHN的预测价值。结果:两组患儿胎龄[(39.11±0.55)周、(38.85±0.72)周]、出生体重[(3.30±0.49)kg、(3.24±0.55)kg]、男性比例[60(55.6%)、30(68.2%)]差异均无统计学意义(均P>0.05)。观察组右室内径[(9.57±0.35)mm]、肺动脉压力[(51.36±5.91)mmHg]及NT-proBNP[(25436.83±12343.18)ng/L]水平显著高于对照组[分别为(8.77±0.41)mm、(31.24±5.11)mmHg、(11267.09±4405.48)ng/L,P均<0.05]。观察组患儿治疗前血浆IL-1β[(31.24±5.25)ng/L]及IL-1ra[(41.94±10.13)ng/L]表达水平明显高于对照组[分别为(18.27±4.47)ng/L、(21.47±8.76)ng/L,P均<0.05]。观察组患儿治疗后血浆IL-1β[(10.46±3.17)ng/L]及IL-1ra[(10.58±2.94)ng/L]表达水平明显低于治疗前[分别为(31.24±5.25)ng/L、(41.94±10.13)ng/L,P均<0.05]。多因素Logistic回归分析显示,IL-1β及NT-proBNP是败血症新生儿合并PPHN的独立危险因素(P<0.05)。ROC曲线分析显示,IL-1β(AUC=0.915)及NT-proBNP(AUC=0.894)对败血症新生儿合并PPHN的发生有较高的预测价值(P<0.05),IL-1β�Objective To explore the expression and clinical significance of IL-1βand IL-1βreceptor antagonist(IL-1ra)in persistent pulmonary hypertension of the newborn(PPHN)secondary to sepsis.Methods The newborns with sepsis were enrolled in the Department of Neonatal Intensive Care Unit(NICU)of Xi′an Children′s Hospital from January 2018 to November 2020.The newborns with sepsis were divided into two groups:the newborns without PPHN(n=108)were the control group and the newborns with PPHN(n=44)were the experimental group.Clinical data,laboratory examination and bedside echocardiography of all the newborns were collected to analyze the differences between the two groups.The expression levels of IL-1βand IL-1ra in neonatal plasma of the two groups were detected by enzym-linked immunosorbination(ELISA),and their roles in neonatal sepsis with PPHN were further analyzed.The risk factors of neonatal sepsis with PPHN were analyzed by multivariate Logistic regression,and the early prediction value of the risk factors for neonatal sepsis with PPHN were evaluated by the receiver operating characteristic(ROC)curve.Results There were no significant differences in gestational age[(39.11±0.55)w vs(38.85±0.72)w],birth weight[(3.30±0.49)kg vs(3.24±0.55)kg]and proportions of males[60(55.6%)vs 30(68.2%)]between the two groups(P>0.05).The right ventricular diameter[(9.57±0.35)mm],pulmonary artery pressure[(51.36±5.91)mmHg]and the level of N-terminal brain natriuretic peptide(NT-proBNP)[(25436.83±12343.18)ng/L]significantly increased in the experimental group than those in the control group[(8.77±0.41)mm,(31.24±5.11)mmHg,(11267.09±4405.48)ng/L,respectively,P<0.05].Before treatment,the expression levels of plasma IL-1β[(31.24±5.25)ng/L]and IL-1ra[(41.94±10.13)ng/L]in the experimental group were significantly higher than those in the control group[(18.27±4.47)ng/L,(21.47±8.76)ng/L,respectively,P<0.05].The expression levels of plasma IL-1β[(10.46±3.17)ng/L]and IL-1ra[(10.58±2.94)ng/L]in the experimental group after trea

关 键 词：败血症 持续性肺动脉高压 新生儿 白细胞介素-1Β 白细胞介素-1受体拮抗剂 

分 类 号：R722.1[医药卫生—儿科]